Organization
MFDC OF INDIANA, INC
Active
Other names
Georgetown Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER PARDUE (DIRECTOR OF REVENUE CYCLE)
(502) 548-2402
Entity
Organization
Contact information
Practice address
5525 GEORGETOWN RD STE B, INDIANAPOLIS, IN 46254-3717
(502) 254-8500
Mailing address
PO BOX 437169, LOUISVILLE, KY 40253-7169
(502) 254-8500
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
Other
Enumeration date
01/15/2025
Last updated
02/10/2025
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